Best Practices in Lung Management Experiences using MetaNeb Paula Abbas, BSN, RN, CPTC LifeSource Donation Coordinator Region 7 Meeting February 13, 2015

Current options for CPT Metaneb 4.0 Vest therapy CPT Manual CPT

Downfalls of manual and vest CPT Time consuming (manual) Often not performed correctly or frequently enough Vest stays on patient, potentially interfering with other treatments Disturbing to families/seen as violent (vest) Limited to loosening secretions

The MetaNeb® System Description 4/15/2017 The MetaNeb® System Description The MetaNeb® System is a therapeutic device that uses a systematic approach to enhance mucus clearance and resolve or prevent atelectasis. The MetaNeb® System offers 3 therapies: Continuous Positive Expiratory Pressure (CPEP) Lung expansion therapy for the treatment and prevention of pulmonary atelectasis Continuous High Frequency Oscillation (CHFO) Secretions mobilization therapy Aerosol Mode Aerosol Therapy Provides supplemental oxygen when used with compressed oxygen The MetaNeb System is a therapeutic device, available in acute care settings, which uses a systematic approach to enhance secretion clearance and resolve or prevent patchy atelectasis. The three therapies provided within A MetaNeb Treatment include: CHFO Therapy, which stands for Continuous High Frequency Oscillation and provides secretion clearance CPEP Therapy, which stands for Continuous Positive Expiratory Pressure, and provides lung expansion therapy Aerosol Therapy, which is continuously delivered in any of the modes It also provides Supplemental oxygen when connected to your 50 psi oxygen gas source

Absolute Contraindications The MetaNeb® System Absolute Contraindications Untreated tension pneumothorax Untrained or unskilled operator There are absolute contraindication for airway clearance which are listed And for the MetaNeb System which are listed We have listed some relative contraindications specific to the MetaNeb System These reflect conditions that should cause pause since it is a prescription device the physician must weigh the benefit against any risk to the patient.

LifeSource’s Experience Device became available through Hill Rom in 2012/2013 and several hospitals in our region began using the device in 2013 Lifesource worked with Hill Rom rep and hospital RTTs to begin using the device on organ donors Noted decreased atelectasis and better secretion removal with use

LifeSource Experience cont. Hill Rom rep came to LifeSource skills day to demonstrate set up and use of Metaneb to clinical staff in 2014. LifeSoure worked with Hill-Rom legal rep to set up an exclusive rental program for use at 2 of our donor hospitals. (for use exclusively for organ donors) Unusual rental circumstances for organ donors requiring daily rental rate.

LifeSource Experiences cont. The 2 hospitals with the rental agreements LOVE the metaneb and are considering purchasing the equipment RTTs verbalize use of this device has prevented escalation of care to oscillators or other High frequency ventilator modes. Significant reduction of atelectasis and increase in secretion removal noted by staff, demonstrated by CXR improvement, better oxygenation, and decreased secretions.

LifeSource Experiences cont. Treatment not as violent as the vest. Families not bothered by treatment Easy to use RTTs with overwhelming positive feedback regarding device Research data available on Hill-Rom website

LifeSource MetaNeb Protocol 10 minute treatment q 2 hrs Used with neb q 4 hrs, and q 2 hrs prn HOB up 30 degrees during treatment Used in conjunction with q 4 hr recruitment maneuvers and O2 challenges Used also in non-lung donors to improve oxygenation and secretion clearance

Questions?